| [ Summary ] |
NUD is a symptom complex, characterised by post prandial upper abdominal discomfort or pain, early satiety, nausea, vomiting, abdominal distension, bloating, and anorexia in the absence of organic disease, although its pathophysiology remains unclear. In the literature, basal and peak acid outputs were reported not to be different between patients with NUD and control groups. Therefore, hypersecretion of gastric acid seems not to be important in the development of NUD. In these patients, gastrointestinal motor abnormalities and visceral hypersensitivity may be more important as pathophysiological mechanisms.
There is some evidence that antisecretory therapy (with H2 receptor antagonists or proton pump inhibitors) is effective in the treatment of NUD except dysmotility-like one. Some meta-analysis studies show that antisecretory treatment is modestly superior to placebos in the treatment of NUD, although the publication's bias makes its interpretation difficult. Establishment of a method which is useful for the identification of cases which respond to antisecretory treatment is an urgent need. |